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A “toxic cocktail” of fear and defensiveness still stops patients objecting to poor care a year after the extent of the Mid Staffordshire scandal was laid bare, the NHS complaints chief said.

Dame Julie Mellor’s comments came as the leader of the public inquiry into Mid Staffordshire NHS Trust urged doctors and nurses to take responsibility for ensuring that the health service put patients first. Robert Francis, QC, who chaired the inquiry, said that any staff who believed that the scandal could not be repeated were “seriously mistaken”. He added: “I would love to stop receiving letters from poor benighted